Office vs Lawn

I saw a patient in the Chronic Care Clinic today who I was sure had cirrhosis. Skinny guy, big tense belly. Spiders, caput...I was sure it was ascites. Still, you gotta do those maneuvers to confirm it: shifting dullness, fluid wave, you know the drill.

But clinic in Kisoro means lawn furniture. I’m sitting behind a desk, and this guy’s in one of those green plastic deck chairs in front of me. That's the entire room. It's not that I'm a bad writer and I can't think of other details. I can describe the dirt on the floor if you want: it's brown and powdery. But that's all, there's a desk and two chairs and some dirt. No crinkly roll of sterile paper to cover the examining table. No examining table at all.

The message to me is clear: don’t examine the patient unless they’re sick enough to be admitted to the hospital.

But I'm stubborn, and I cling to my antiquated ways.

So I made the guy lie on my desk.